Strange isn't it that a comprehensive explanation of conversion is often hard to find....agree this is getting there! Thank you for posting.
However, no mention of vit B12, vit D, folate and ferritin which all need to be optimal in order to support thyroid function and consequently conversion.
This review is limited because the author is focused on type-1 deiodinase (D1) that is upregulated in hyperthyroidism and converts T4 to T3 and rT3. D2 is the important deiodinase as it converts T4 to T3 and regulates local T3 levels. If you are hypo you want D1 not D2.
Low D1 activity as mentioned in the review can cause low serum T3 but in my view is unlikely. to be relevant to hypothyroid sufferers. If this was the problem you would fully recover with a small amount of L-T3, just enough to give a normal fT3. This rarely happens.
It is a good blog post but a lot of those interventions are beyond the scope of conventional medicine. So doctors won’t ever tell you do those things.
The other thing to highlight is TSH. It is incredibly important. Going too low while chasing that sweet spot for FT4 and FT3 is detrimental as it affects the way your body and the brain creates it’s own thyroid hormone via thyroid peroxidase, using the sodium iodine symporter which picks up iodine from the passing blood supply. Thus a low TSH over a period of time results in reduced iodine absorption by the thyroid. So your thyroid essentially goes to sleep for the duration of time you are “over medicating”.
This can result in a disruption to the HPA-O- axis ( hypothalamic, adrenal, ovarian axis ). They are all connected. This is something I wasn’t previously aware of.
By time I was diagnosed with hashis all that was left of mine was 1 little shrivelled bit in upper right. If I have understood correctly people like me must be given t3… I remember the change on even 60 mcg desiccated ( ultimately 180)
At least it’s an article that’s tackling a subject not often out there. (Just a bit tricky replicating that ideal diet of oysters, crab etc etc when you’re on a low salary).
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